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பிறப்பொக்கும் எல்லா உயிர்க்கும் சிறப்பொவ்வா செய்தொழில் வேற்றுமை யான்.

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Presentation on theme: "பிறப்பொக்கும் எல்லா உயிர்க்கும் சிறப்பொவ்வா செய்தொழில் வேற்றுமை யான்."— Presentation transcript:

1 பிறப்பொக்கும் எல்லா உயிர்க்கும் சிறப்பொவ்வா செய்தொழில் வேற்றுமை யான்.

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5 CLASSIFICATION MIDLINE SWELLING : 1.Sublingual dermoid 2.Thyroglossal cyst 3.Subhyoid bursitis LATERAL SWELLINGS; 1.Digastric triangle -plunging ranula 2.Carotid triangle -bronchial cyst POSTERIOR TRIANGLE; 1.Cytic hygroma

6 THYROGLOSSAL CYST  Fibrous cyst that forms from a persistent thyroglossal duct  midline swelling with slight inclination to left  Out pouching from floor of first and second bronchial pouch

7  pseudo stratified columnar epithelium with lymphoid tissue, fluid is formed by un- obliterated duct it contains cholesterol crystals  tubulo-dermoid type  may contain thyroid tissue /only functiong thyroid tissue  age yrs of females

8 COMMON SITES 1. SUBHYOID -MC 2. THYROID CARTILAGE 3. SUPRAHYOID 4. FLOOR OF THE MOUTH 5. BENEATH TH FORAMEN CAECUM

9 SYMPTOMS:  Painless  Oval in shape  Gradually increased in size  Skin free  Occasionally -Translucent  mobility-sideways  Moves on protrusion of tongue  Fluctuant  Lymph node enlarged if infected  Examine the base of the tongue

10 COMPLICATIONS:  Recurrent infection  fistula formation  Malignancy  Cosmetic  In advent surgery INVESTIGATIONS:  USG thyroid/MRI  FNAC  Uptake studies

11  Subhyoid bursal cyst  Sublingual dermoid  Enlarged cervical node  Ectopic thyroid  Solitary nodule from isthmus DIFFERENTIAL DIAGNOSIS

12 TREATMENT: Excision-track with body of hyoid bone Sistrunk’s operation

13 SUBLINGUAL DERMOID  Sequestration dermoid  Entrapped ectoderm level of first or mandibular arch  Above or below mylohyoid  Lined by squamous epithelium /  Contain -sweat glands/sebaceous glands  Cheesy materials  It never contains hair

14 SUBLINGUAL DERMOID  Occurs at years  Male= female  Position :supra omohyoid or sublingual variety  Under the tongue or beneath the chin  Mucosa free/ fluctuation positive  non -Transillumination  Intra omohyoid or cervical variety  bimanual palpation

15 Sublingual drmoid cyst  Investigation - USG /MRI/FNAC  Treatment- excision under GA(intra/extra oral)

16 BRONCHIAL CYST  congenital cyst persistence of second bronchial cleft ecto derm  At the upper part of sternocleidomastoid  Posteromedial part in the deeper plane  Oval in shape  Smooth surface /soft  Well-defined  Fluctuation positive  Trans illumination negative

17 BRONCHIAL CYST not reducible/compressible Cholesterol crystals on aspirated fluid

18 BRONCHIAL CYST COMPLICATIONS: Cosmetic Infection fistula formation DIAGNOSIS: FNAC MRI/FISTULAGRAM TREATMENT: Excision

19 Course BRANCHIALCYST  Subcutaneous at the level of upper border thyroid cartilage  Pass through bifurcation of common carotid artery  Superficial to internal carotid,deep to ext.carotid  Deep to the post.belly of digastric and stylohyoid muscle  Superficial to IJV,hypoglossal,glossopharyngeal nerves  Pierces the sup.constrictor,open behind post.pillar of the tonsil.

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21 Rx:Excision ( STEP - LADDER OPERATION ) The Neck of the cyst passes between the int and ext carotid art. Can Recur.

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23 Ranula  Cystic swelling floor of mouth  Mucous extravasation from sublingual salivary gland  Plunging Ranula, extend through FOM muscles into neck

24  The name is derived form the word rana, because the swelling may resemble the translucent underbelly of the frog.

25 Plunging ranula  Penetrates Mylohyoid muscle to enter neck  Soft painless fluctuant dumb- bell shaped swelling  Bi digital palpation

26 Plunging ranula  Rare form of retention cyst  May arise from SM/SL SG  Mucous collects around gland  Surgical excision via neck

27 CYSTIC HYGROMA  Arises from jugular lymph sac 6 th to 14 th week  sequestration of lymphatic sac  Multiloculated  Lined by endothelium  Posterior triangle of neck  Ascends to ear lobule or descends to axilla  Early infancy or at birth presentation  Lump in the lower third of posterior triangle

28 CYSTIC HYGROMA  Increases in size  smooth  Indistinct margin  Smooth or lobulated  Cystic consistency  Impulse on coughing  Can be compressible  Translucent brilliantly

29 CYSTIC HYGROMA COMPLICATIONS : Cosmetic Respiratory difficulty Infection following incomplete removal Recurrence INVESTIGATIONS : MRI TREATMENT: Sclerotherapy Hot water injection Subsequent RT for recurrence

30 Subhyoid bursal cyst  Enlargement subhyoid bursa with accumulation fluid  Below the hyoid bone/front of the thyrohyoid membrane  Swelling with pain  Oval with long axis(cf.thyroglossal cyst)  Mid line /move with deglutition  Cystic/fluctuation +/non- transillumation /turbid

31 Subhyoid bursal cyst  Investigation MRI/FNAC  TREATMENT Complete excision-transverse incision

32 THANKS TO MY TEACHERS  PROF.DR.S.NARENDRAN M.S Ph.D TANJAVUR MEDICAL COLLEGE  PROF.DR.A.SUKUMAR M.S Rtd. Director of Medical and Rural services  PROF.DR.C.M.K REDDY FRCS Rtd. Prof. Stanley Medical College  PROF.DR.T.MOHANA PRIYA M.S Sri Ramachandra Medical College and R.I

33  The wood is lovely dark and deep  But I have promises to keep  Miles to go before I sleep

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